Patients Skip the Clipboards with Online Medical Records

By M.L. Baker  |  Posted 05-11-2005
Edward Fotsch wants to take clipboards out of doctors' offices. The CEO of Medem, a company providing Internet-based services to doctors, this week reached out to patients with the chance to create their own online, password-protected personal health records. That way, doctors can grab relevant information from the Internet instead of from scattered slips of paper.

For-profit Medem Inc. was founded by the American Medical Association and other medical societies as a way to help clinicians communicate with patients online. The PHR (personal health record) service is a natural extension of that, Fotsch said. "Instead of filling it out in a waiting room, where you don't have your information, you do it from your home at your own convenience, and you only have to do it once."

After creating their record, patients can print out cards with instructions allowing emergency workers to access relevant information online instead of by quizzing distraught family members.

Otherwise, Fotsch said, "ER [emergency room] people are flying blind, and family members are asked to answer questions they are ill-prepared for."

But critics question whether patients will keep accurate records and whether physicians will view them as reliable, and they note that third-party Web sites are not bound by the same privacy regulations that apply to health care providers and payers.

Unlike similar services offered by other companies, patients will pay nothing for Medem's service, called iHealthRecord. Instead, physicians will pay about $25 a month.

Patients can go to www.ihealthrecord.org to see if their physician offers the service and can start entering information, or they can do so through their physicians' Web sites. Patients can give doctors or family members access to their information by sharing their passwords.

Fotsch said the cost to physicians is much less than that of EMR (electronic medical record) systems, and that it could pay for itself with a single online consultation.

Patients who have created their own PHRs would likely push doctors to use more health information systems. "That's one of the real attractive features of the iHealthRecords. You'll know for sure if the doctor has an EMR," he said. Brown and Toland, an independent provider association in San Francisco, said it would offer the service.

Click here to read about the Defense Department's medical-record system.

Though Fotsch said physicians would offer the service as a market differentiator, he also said patients would have complete control over their records and could easily share them with new doctors. But the iHealthRecord would not be able to store all of the kinds of data that might be part of an EMR.

Patients who sign up also receive education programs and reminders specific to their medical conditions, plus relevant Food and Drug Administration safety warnings.

Medem is working on ways that physicians' EMRs could sync up to a patient's PHR, so the patient does not have to manually update data. Fotsch said 12 EMR vendors called him Monday to talk about making their systems compatible with iHealthRecords.

Most other PHR vendors ask patients to pay for services. Five-year-old FollowMe, from Access Strategies Inc., charges $25 a year to keep information online.

Tiny RedMedic Inc. maintains patients' documents online for a yearly fee of about $35, and promises to fax or phone data to emergency rooms if necessary.

WebMD's Health Manager costs $30 a year and provides personalized health news and action plans. Patients can have their information faxed to their doctor prior to an appointment. CapMed allows patients to keep their data on their computer desktops or on a flash drive that doubles as a key chain, which patients can hand to a doctor. The application-loaded drive costs $75. CapMed also can exchange information within two EMR systems.

CapMed Health general manager Wendy Angst said patients like being able to keep data on their own desktops or flash drives rather than in far-off servers. Still, she said her company might investigate having an interface through Medem, so that patients could download information from iHealthRecord to their CapMed keys.

The company already has a similar collaboration with MedicAlert, which supplies patients with bracelets summarizing medical conditions, lets patients keep medical information online and can supply health information to emergency workers by phone.

Even patients who can't normally access the Internet might find a use for the free PHR. Fotsch said a group of health clinics for migrant workers plans to use the service. "They are implementing the iHealthRecord not to get e-mails out to patients but to have information from one clinic to the next."

Medem is also in talks with one of the large disease-management companies, which aim to curb health care costs by regularly checking on patients with chronic diseases. Such a collaboration could make disease management more effective by involving patients' own doctors, Fotsch said.

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